早期联合应用IL1ra和甲强龙在预防SAP并发ARDS的研究临床医学.docVIP

早期联合应用IL1ra和甲强龙在预防SAP并发ARDS的研究临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：早期联合应用IL1ra和甲强龙在预防SAP并发ARDS的研究临床医学 1 1 资料与方法 3 2 结果 3 3 讨论 5 文2：创伤性连枷胸并发ARDS68例救治分析 6 1 资料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 8 原创性声明（模板） 10 文章致谢（模板） 10 正文 早期联合应用IL1ra和甲强龙在预防SAP并发ARDS的研究临床医学 文1：早期联合应用IL1ra和甲强龙在预防SAP并发ARDS的研究临床医学 【Abstract】 Objective To observe the clinical outcome of combined application of IL-1ra and methylprednisolone in early stage of severe acute pancreatitis （SAP）to prevent acute respiratory distress syndrome（ARDS）. Methods Fifty-six emergency hospitalization patients with severe acute pancreatitis diagnosed by clinical symptoms, orrhology, biochemistry and auxiliary examination, were randomly divided into two groups which were: the experimental group (n=27) and the control group (n=29).The control group was given routine therapy according to the therapeutic principle of SAP, including gastrointestinal decompression, fasting diet, administering somatostatin and anti-acid drugs, sustentacular and symptomatic treatment, while the experimental group was additionally given methylprednisolone 60mg, 2/d,and IL-1ra 25mg/h . with micro pump. After 3～7 days treatment, the ARDS complication incidence and the outcome of two groups were observed. Results In experimental group, two patients were complicated by ARDS, three patients were dead and the rest were recovered, while the control group , nine patients were complicated by ARDS, eight patients were dead. Conclusion Combined application of IL-1ra and methylprednisolone in early stage of SAP could efficiently depress inflammatory exudation of SAP, prevent inflammatory medium releasing, promote innocence turnover, simultaneously reduce the dosage of IL-1ra and decrease hospitalization time. 【Key words】 early;combined application;IL-1ra;methylprednisolone;SAP;ARDS 急性重症胰腺炎（SPA）近年来随着治疗方法增加，个体化治疗的介入以及新药的临床应用，其死亡率有所下降，但仍是 现代 医学的一个难题，近年来有学者认为，在急性重 症胰腺炎的病程 发展 中，部分患者出现SI及ARDS甚至MODF，除以往研究的结果外，部分病情跟介质释放尤其人 白介素-1（IL-